Comparative Pharmacology
Head-to-head clinical analysis: SULFATRIM SS versus SULFISOXAZOLE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: SULFATRIM SS versus SULFISOXAZOLE.
SULFATRIM-SS vs SULFISOXAZOLE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Sulfamethoxazole inhibits bacterial dihydropteroate synthase, blocking folate synthesis. Trimethoprim inhibits bacterial dihydrofolate reductase, blocking reduction of dihydrofolate to tetrahydrofolate. Sequential blockade produces bactericidal synergy.
Sulfisoxazole is a sulfonamide antibiotic that inhibits bacterial dihydropteroate synthase, blocking the synthesis of dihydrofolic acid and ultimately inhibiting bacterial folate synthesis and DNA replication.
1 double-strength tablet (160 mg trimethoprim / 800 mg sulfamethoxazole) orally every 12 hours for 10-14 days.
1-2 g orally once, then 500 mg-1 g orally every 4-6 hours; maximum 6 g/day.
None Documented
None Documented
Clinical Note
moderateSulfisoxazole + Gatifloxacin
"Sulfisoxazole may increase the hypoglycemic activities of Gatifloxacin."
Clinical Note
moderateSulfisoxazole + Rosoxacin
"Sulfisoxazole may increase the hypoglycemic activities of Rosoxacin."
Clinical Note
moderateSulfisoxazole + Trovafloxacin
"Sulfisoxazole may increase the hypoglycemic activities of Trovafloxacin."
Clinical Note
moderateSulfisoxazole + Nalidixic acid
SMX: 9-12 hours (increased in renal impairment); TMP: 8-11 hours (increased in renal impairment); both prolonged in elderly.
Terminal elimination half-life is 5-7 hours in adults with normal renal function; prolonged to 12-20 hours in renal impairment (CrCl <30 mL/min).
Renal excretion of unchanged sulfamethoxazole (SMX) approximately 20%, trimethoprim (TMP) approximately 60%; biliary/fecal elimination minor (SMX <5%, TMP <10%).
Renal excretion accounts for 70-85% of elimination, predominantly as unchanged drug (30-50%) and the N4-acetyl metabolite (15-30%). Biliary/fecal excretion is minimal (<5%).
Category C
Category C
Sulfonamide Antibiotic
Sulfonamide Antibiotic
"Sulfisoxazole may increase the hypoglycemic activities of Nalidixic acid."